Tumor marker | Normal value | Primary tumor(s) | Additional associated malignancies | Benign conditions | Level above which benign disease is unlikely | Sensitivity |
---|---|---|---|---|---|---|
CA 27.291,2 | < 38 units per mL | Breast cancer | Colon, gastric, hepatic, lung, pancreatic, ovarian, and prostate cancers | Breast, liver, and kidney disorders, ovarian cysts | > 100 units per mL | Elevated in about 33% of early-stage breast cancers and about 67% of late-stage breast cancers |
CEA3,4 | < 2.5 ng per mL in nonsmokers < 5 ng per mL in smokers | Colorectal cancer | Breast, lung, gastric, pancreatic, bladder, medullary thyroid, head and neck, cervical, and hepatic cancers, lymphoma, melanoma | Cigarette smoking, peptic ulcer disease, inflammatory bowel disease, pancreatitis, hypothyroidism, cirrhosis, biliary obstruction | >10 ng per mL | Elevated in less than 25% of early-stage colon cancers and 75% of late-stage colon cancers |
CA 19-95 | < 37 units per mL | Pancreatic cancer, biliary tract cancers | Colon, esophageal, and hepatic cancers | Pancreatitis, biliary disease, cirrhosis | > 1,000 units per mL | Elevated in 80% to 90% of pancreatic cancers and 60% to 70% of biliary tract cancers* |
AFP6 | < 5.4 ng per mL | Hepatocellular carcinoma, nonseminomatous germ cell tumors | Gastric, biliary, and pancreatic cancers | Cirrhosis, viral hepatitis, pregnancy | > 500 ng per mL | Elevated in 80% of hepatocellular carcinomas |
Nonseminomatous germ cell tumors: see β-hCG below | ||||||
β-hCG7,8 | < 5 mIU per mL | Nonseminomatous germ cell tumors, gestational trophoblastic disease | Rarely, gastrointestinal cancers | Hypogonadal states, marijuana use | > 30 mIU per mL7 | AFP or β-hCG elevated in 85% of nonseminomatous germ cell tumors; elevated in only 20% of early-stage nonseminomatous germ cell tumors |
CA 1259–11 | < 35 units per mL | Ovarian cancer | Endometrial, fallopian tube, breast, lung, esophageal, gastric, hepatic, and pancreatic cancers | Menstruation, pregnancy, fibroids, ovarian cysts, pelvic inflammation, cirrhosis, ascites, pleural and pericardial effusions, endometriosis | > 200 units per mL11 | Elevated in about 85% of ovarian cancers; elevated in only 50% of early-stage ovarian cancers |
PSA12–14 | < 4 ng per mL for screening Undetectable level after radical prostatectomy | Prostate cancer | None | Prostatitis, benign prostatic hypertrophy, prostatic trauma, after ejaculation | > 10 ng per mL12 | Elevated in more than 75 percent of organ-confined prostate cancers14 |